Volunteer Counselor Application

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    ATTENTION POTENTIAL COUNSELORS! Please complete this form. Also read the Pastoral Reference Form carefully and follow the instructions. (We will not process your application until the pastor reference form is received.)
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    First Name
    Middle Name
    Last Name
    Home Phone
    Cell Phone
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    E-mail Address
    Home Address
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    City
    State
    Zip Code
    Age
    Date of Birth
     
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    Gender
    Male
    Female
    School (if in college)
    Year
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    Occupation (if out of school)
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    Church You Attend
    City
    Pastor
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    1. Write out your personal testimony in 300 words or less.
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    2. List any previous experience at CSBC (camper, counselor, other worker, also indicate number of years).
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    3. What other previous experiences and/or training have you had that might help you to be a good camp counselor?
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    4. List hobbies, crafts, musical abilities, etc. that you regularly use.
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    5. How would you lead a camper to Christ? What scriptures would you use?
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    6. Part of being a camp counselor is answering camper questions about ethical issues and situations. (Questions about drinking, smoking, drugs, etc.) Using some scriptures, how would you answer these questions?
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    PLEASE CHECK THE CAMP(S) YOU ARE ELIGIBLE FOR AND INTERESTED IN COUNSELING AT
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    Junior (ages 8-10)
    Intermediate (ages 11-12)
    Junior High (ages 13-14)
    Senior High (ages 15-18)
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    The camp policy for counselors is that you need to be 16 years old or older and you must be 4 years older than the campers you are counseling. NOTE: SHOULD COUNSELOR OR CAMPER DISMISSAL BE CONSIDERED, THE DIRECTOR, CAMP PASTOR, LEAD COUNSELORS, AND ADMINISTRATOR WILL CONFER BEFORE ACTION IS TAKEN.
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    Primary Screening Form for Crystal Springs Camp

    This is to be completed by all applicants for any position (volunteer or compensated) involving the supervision or custody of minors. This is not an employment application form, but rather an instrument to help implement a safe and secure environment for our children and youth ministries. This is a confidential form and the information herein will be accessible only to the leadership team of Crystal Springs Camp.

    PERSONAL INFORMATION

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    Name
    Date
     
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    Social Security #
    State
    Zip
    Home Phone
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    Date of Birth
     
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    Have you ever been charged or convicted of a felony?
    Yes
    No
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    Have you ever been charged or convicted of any misdemeanor of sexual nature?
    Yes
    No
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    If yes to either of the above two questions, please explain
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    Applicant’s Statement

    The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give any information (including opinions) that they may have regarding my character and fitness of children or youth work. In consideration of the receipt and evaluation of this application by Crystal Springs Camp, I hereby release any individual, church, organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively or individually, from any liability for damages of whatever kind or nature which may at any time result to me, my heirs, my family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Should my application be accepted, I agree to be bound by the policies of Crystal Springs Camp, and to refrain from unscriptural conduct in performance of my services on behalf of the camp. I realize and agree that any photos or recordings taken of me during the summer may be used in camp promotional material. I further understand that Crystal Springs Camp will thoroughly pursue the safety of minors being served by their ministries. To that end, they may check my name against the list of registered sex offenders in the United States. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement which I have read and understand.

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    Applicant's Signature
    Date
     
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